“In recent years, health care, especially its medical or curative aspect, has captured as never before the interest of the public, political leaders and an attentive media” (Sultz & Young, 2006 p. 1).
The US health care system, as is the case in most other countries, is experiencing some major dilemmas and deficiencies (2006). The four basic functional components of the U.S. health care delivery system include financing, insurance, delivery, and quality (2006).
Addressing problems that plague these specific functional components of health care delivery is vital (2006). New health care legislation and ultimately policy reflects public opinion at the federal, state and local levels (2006). Various pieces of pending legislation in each area of health care delivery including insurance, finance, delivery, and quality are constantly being considered at the local, state and federal levels.
There are currently an estimated 46 million Americans without health insurance. Senator Edward Kennedy, chairman of the senate’s Health, Education, Labor, And Pensions Committee proposed an expansion of health care coverage that would cover an estimated 39 million of those people once implemented. (United States, 2009)
Kennedy’s health care plan is a large initiative with the stated goal of providing “Quality, Affordable healthcare to all Americans.” (United States, 2009)
The plan is detailed, complicated and expensive. At the end of the day, it is uncertain how effective this particular plan will be. (United States, 2009)
The plan contains a number of different elements that are to come together to reflect a policy that guarantees health care is provided at an affordable rate for all Americans. (United States, 2009)
In the first place, this plan enforces universal healthcare by simply requiring at law that it be purchased, and offering a tax penalty to those who do not comply. (United States, 2009) Those who cannot afford an acceptable policy will be subsidized by the government. (United States, 2009)
The plan also requires employers to offer insurance and subsidize its payment, or be subject to a federal tax. (United States, 2009) A number of details in this plan are subject to debate, but few can argue that the goal of healthcare coverage for all Americans, particularly children, is a laudable goal. (United States, 2009) The Kennedy plan will help ensure that preventative care is available, which, in the long run, will save billions in acute care costs. (United States, 2009)
The most difficult and contentious aspect of healthcare legislation is the financing. It would be difficult indeed for a politician to argue that healthcare should not be affordable to all, or that children should not have access to healthcare, but the sticking point upon which politicians stake their objections is the method for paying for such expansive and comprehensive care.
In the state of California, Assembly Bill number 1383 was proposed in a recent session to outline the manner in which hospital visits in public and private hospitals by patients who are members of the States’ Medi-Cal program are to be compensated for inpatient visits. (2009)
This bill deals primarily with the disposition of federal funding left over after the subsidies for a given fiscal year have been paid. (State of California, 2009) The bill proposes that remaining funds be paid out to hospitals to defray the cost of emergency treatment of the uninsured, rather than reverting to a general government fund. (State of California, 2009)
The financing of universal healthcare is often absorbed by the emergency care units of hospitals. (State of California, 2009) Because hospitals do not refuse emergency treatment to the indigent, they are often left “holding the bag” for uninsured patients who come in for emergency care. (State of California, 2009) For many Americans, acute emergency care is the only type of medical care they receive.
(State of California, 2009) Thus the forces of the market drive such individuals to avoid expensive (if uninsured) preventative or well care to seek emergency treatment only in acute cases, which in turn leaves the emergency departments with no choice but to treat the patients, and no recourse to collect payments. (State of California, 2009)
AB 1383 is an effort to further allay the costs of providing free care to emergency patients that faces hospitals in California. (State of California, 2009) The bill is designed to ensure that additional federal funding is allocated to those hospitals that bear the greatest number and volume of uninsured emergency cases. (State of California, 2009)